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Renal transplantation in the presence of<jats:styled-content style=\"fixed-case\">APS<\/jats:styled-content>carries a risk of early graft loss from arterial or venous thrombosis, or thrombotic microangiopathy (<jats:styled-content style=\"fixed-case\">TMA<\/jats:styled-content>). Whilst perioperative anticoagulation reduces the risk of large vessel thrombosis, it may result in significant haemorrhage, and its efficacy in preventing post\u2010transplant<jats:styled-content style=\"fixed-case\">TMA<\/jats:styled-content>is uncertain. Here, we report a patient with end\u2010stage kidney disease (<jats:styled-content style=\"fixed-case\">ESKD<\/jats:styled-content>) due to lupus nephritis and<jats:styled-content style=\"fixed-case\">APS<\/jats:styled-content>, in whom allograft<jats:styled-content style=\"fixed-case\">TMA<\/jats:styled-content>developed soon after transplantation despite partial anticoagulation.<jats:styled-content style=\"fixed-case\">TMA<\/jats:styled-content>resolved with plasma exchange\u2010based therapy albeit with some irreversible graft damage and renal impairment. We discuss the differential diagnosis of post\u2010transplant<jats:styled-content style=\"fixed-case\">TMA<\/jats:styled-content>, and current treatment options.<\/jats:p>","DOI":"10.1111\/nep.12217","type":"journal-article","created":{"date-parts":[[2014,2,18]],"date-time":"2014-02-18T13:23:52Z","timestamp":1392729832000},"page":"177-185","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Antiphospholipid syndrome in renal transplantation"],"prefix":"10.1111","volume":"19","author":[{"given":"Thomas D","family":"Barbour","sequence":"first","affiliation":[{"name":"Department of Nephrology Royal Melbourne Hospital Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amy","family":"Crosthwaite","sequence":"additional","affiliation":[{"name":"Department of Nephrology Royal Melbourne Hospital Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin","family":"Chow","sequence":"additional","affiliation":[{"name":"Department of Nephrology Royal Melbourne Hospital Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Moira J","family":"Finlay","sequence":"additional","affiliation":[{"name":"Department of Anatomical Pathology Royal Melbourne Hospital Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nathan","family":"Better","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine Royal Melbourne Hospital Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter D","family":"Hughes","sequence":"additional","affiliation":[{"name":"Department of Nephrology Royal Melbourne Hospital Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Solomon J","family":"Cohney","sequence":"additional","affiliation":[{"name":"Department of Nephrology &amp; Medicine Northwestern Academic Centre University of Melbourne Melbourne Victoria Australia"},{"name":"Department of Epidemiology &amp; Preventive Medicine Monash University Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2014,3,24]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1112830"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1538-7836.2006.01753.x"},{"key":"e_1_2_7_4_1","first-page":"330","article-title":"Guidelines on the investigation and management of antiphospholipid syndrome","volume":"7","author":"Keeling D","year":"2011","journal-title":"Br. 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